=====================================================
General NPI Number Information
=====================================================
NPI Number | 1306634191
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | MARION REGIONAL HEALTH - WINFIELD, INC.
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 04/30/2025
-----------------------------------------------------
Last Update Date | 04/30/2025
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 255 MEDICAL DR STE 3
-----------------------------------------------------
City | WINFIELD
-----------------------------------------------------
State | AL
-----------------------------------------------------
Zip | 35594-5005
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 205-487-7536
-----------------------------------------------------
Fax | 205-487-7929
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 808 VARSITY DR
-----------------------------------------------------
City | TUPELO
-----------------------------------------------------
State | MS
-----------------------------------------------------
Zip | 38801-4613
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 662-377-3868
-----------------------------------------------------
Fax | 662-377-2057
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | CORPORATE SECRETARY
-----------------------------------------------------
Name | BRUCE TOPPIN
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone | 662-377-4229
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 2084P0805X
-----------------------------------------------------
Taxonomy Name | Geriatric Psychiatry Physician
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------
Taxonomy #2
-----------------------------------------------------
Taxonomy Code | 2084N0400X
-----------------------------------------------------
Taxonomy Name | Neurology Physician
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------